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�, <br />;�. <br />�, <br />_ _ :� <br />- ,� <br />; . ,. <br />: Sewer Application and ��ermi� ;y ,� ; <br />� _. � � �� �, _: „ -- <br />� _;;� �:.�.,��; <br />�_ ..__,.. _ . -. <br />j 2S'7:� DATE `_:i-tt-,�u <br />ServiceAddress 80?2 aeverly 1.n�,e <br />Billing Address <br />City, State, Zip Evereec uA 98203 <br />Owner Pedro Knlcue <br />Connecti,.., �y CCH Conc[ruction <br />Address — �15a4 18och sc Nk <br />Stnn:+ood 98292 <br />Phone 653-5201 <br />Legal Descriptfon: <br />Lot 1 of SP 39-93 <br />Block <br />Plat -- <br />Unplatted Descriptfon: --- <br />Type oi Permit �IEN connectlon <br />Remarks <br />IMPORTANT! <br />CALL 1-800-42A-5.555 46•HOURS <br />PRlOR TO DIGGIRVG <br />CALL 25�-88�0 F0� IhSPi:r,TION <br />Utility Account No. <br />CHART N0. <br />TO POSTING �" ����-s� <br />PermitFee $ ��•�� — — <br />Connection Charge <br />Trunk $ <br />Lateral S <br />Total Connection Charge $ -�- <br />Utility Development Fee <br />Water g 179.00 <br />Sewer S <br />G7I.06 <br />Total Development Fee $ 65U.nU <br />Sewer Bond District <br />Abutting Lot Line <br />N, S, E, W n' <br />Appraved By <br />Issued By � <br />Customer Signatura <br />Inspection By � <br />Date Inspected � '� y� f <br />SEE SKETCH ATTACHED ', ��J 7 g 5 <br />INSPECTION <br />